Larry Don Wilson, PA-C is a
Physician Assistant - Medical based in Bacliff, Texas. Larry Don Wilson is licensed to practice in Texas (license number PA00742) and his current practice location is
1136 Grand Ave, Bacliff, Texas. He can be reached at his office (for appointments etc.) via phone at
(281) 339-5018.
NPI number for Larry Don Wilson is 1306848981 and his current mailing address is 2826 Forest Hills Dr, League City, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1306848981.
Provider's Profile
| Full Name | Larry Don Wilson |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 1136 Grand Ave, Bacliff, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1306848981
- Provider Enumeration Date: 08/12/2005
- Last Update Date: 12/21/2010
Medical Identifiers
Medical identifiers for Larry Don Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306848981 | NPI | - | NPPES |
| PA00742 | Other | TX | STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | PA00742 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Don Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Larry Don Wilson, PA-C
2826 Forest Hills Dr,
League City, TX 77573-5750
Ph: (281) 334-6328 | Larry Don Wilson, PA-C
1136 Grand Ave,
Bacliff, TX 77518-2760
Ph: (281) 339-5018 |
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